Observations On the Contrary

Thinking about Charles II

BMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b2771 (Published 08 July 2009) Cite this as: BMJ 2009;339:b2771
  1. Tony Delamothe, deputy editor, BMJ
  1. tdelamothe{at}bmj.com

    Charles II sometimes backed scientific evidence and sometimes backed belief. How different will the next King Charles be?

    The heir to the British throne has been at the centre of controversy again lately—for his last minute intervention to stop a building development he didn’t like and for the dodgy claims made for tinctures produced by his company.

    While Prince Charles has form when it comes to architectural scraps, the Advertising Standards Authority’s judgment against his company, Duchy Originals, broke new ground: its marketing was the first in the United Kingdom to fall foul of new European regulations governing alternative medicines (Financial Times, 6 May, www.ft.com/cms/s/0/5e108746-39d7-11de-b82d-00144feabdc0.html).

    One of Prince Charles’s objections to the new development was that it was unsympathetic to the nearby Royal Hospital, founded by Charles II. Which set me thinking about the reign of Prince Charles’s namesake. Building the Royal Hospital, a retirement home for British soldiers unfit for further duty, seems A Good Thing. So, too, does Charles II’s support of the fledgling Royal Society, formed within months of the restitution of the monarchy. (The society translates its motto as “Take nobody’s word for it,” which expresses its determination “to withstand the domination of authority . . . and to verify all statements by an appeal to facts determined by experiment.”)

    But what then are we to make of the stories that Charles II touched 100 000 of his subjects to cure them of scrofula (tuberculous lymphadenopathy)? At the time it was believed that English and French monarchs could cure the disease by their touch, having received this power from Saint Remigius via Edward the Confessor.

    I wonder which will be the more powerful influence during the reign of Charles III: scientific evidence or belief? Rightly or wrongly, Prince Charles is widely perceived as being swayed much more strongly by belief. And finding the next king apparently lined up among the opposition is making the lives of the pro-science camp that much harder.

    This matters because medicine is currently in the midst of a culture war between conventional and complementary medicine, with disputes about scientific evidence at its heart. Unsubstantiated claims for the efficacy of Echinacea, Hypericum, and detox tinctures tripped up the prince’s company with the Advertising Standards Authority. But similar skirmishes are breaking out all over the place.

    Last month Stephen Evans, a professor of pharmacoepidemiology, described it as “tragic that we now have a respected body, the Medicines and Healthcare products Regulatory Agency (MHRA), granting a licence for [Arnica 30 pills] for which there is not only no evidence of efficacy but good evidence against any efficacy” (BMJ 2009;338:b2332, doi:10.1136/bmj.b2332). David Colquhoun thinks the labelling of this homoeopathic remedy is “illegal” and makes a “mockery” of the aims of the MRHA (BMJ 2009;338:b2333, doi:10.1136/bmj.b2333). In this week’s journal Edzard Ernst, Britain’s first professor of complementary medicine, disputes the evidence that underpins the British Chiropractic Association’s libel case against the science writer Simon Singh (BMJ 2009;339:b2766, doi:10.1136/bmj.b2766).

    Meanwhile, on the battlefield, rumours thrive. Why doesn’t the Department of Health first decide whether a treatment works before fussing about how to regulate it or how to train its practitioners? Why doesn’t the department take the obvious decision of referring all complementary treatments to the National Institiute for Health and Clinical Excellence (NICE) for its evaluation? How has the MRHA got itself into such a state over complementary treatments that respected researchers use words like “tragic,” “illegal,” and “mockery” when discussing its actions?

    Bloggers have been joining the dots and believe they can discern the presence of Prince Charles, that indefatiguable letter writer, behind these curiosities. But evidence for this is hard to come by, not least because the Freedom of Information Act exempts communications between the royal family and the government. On the specific issue of homoeopathy, the prince’s principal private secretary, Michael Peet, told the producer of the 2007 television documentary, The Meddling Prince, that the prince had never written to the MRHA on the topic nor had met the agency’s chairman to discuss it.

    Sir Michael had, however, written to complain to Edzard Ernst’s vice chancellor about Ernst’s scathing criticisms of a report on complementary medicine that had been commissioned by the prince (Times, 24 Aug 2005, www.timesonline.co.uk/tol/news/uk/article558458.ece). Ernst was eventually let off after a 13 month investigation with dark warnings from his vice chancellor about future disciplinary action (BMJ 2008;337:a2063, doi:10.1136/bmj.a2063). Sir Michael said that his letter of complaint was not prompted by the prince, who was unaware it had been written.

    In the newspaper article that had precipitated the investigation, Ernst said that the Prince of Wales “seems to have overstepped his constitutional role,” a charge repeated by The Meddling Prince. Richard Rogers, the architect whose building development was scuppered last month, has gone further, demanding a public inquiry into the constitutional validity of the prince’s interventions in architecture, medicine, farming, and the environment.

    On the question of such activism, does the reign of Charles II have any pointers for the future Charles III? It’s hard to be sure. The British monarchy’s constitutional powers were severely curtailed by the Glorious Revolution of 1688, hailed as a landmark in the long transfer of power from the Crown to Parliament. That wasn’t during the reign of Charles II, however, but three years later.

    Notes

    Cite this as: BMJ 2009;339:b2771